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Objective: To study the effect of alpha-lipoic acid (ALA) on cognitive functions in patients with non-insulin dependent diabetes mellitus type 2 (DM-2) and thick fiber polyneuropathy., Material and Methods: The MoCA test was used to assess cognitive functions, and vibrometry («Somedic» vibrometer) was used to assess the function of thick fibers. Patients in group 1 ( n =37) received alpha lipoic acid (ALA) in a dose of 600 mg per day for 16 weeks, patients in group 2 ( n =41) started taking ALA 8 weeks after the start of the study., Results: Comparison of both groups showed an increase in the indicators of the MoCA test in group 1 after 8 weeks ( p =0.0025) with a further plateau and an improvement in vibration sensitivity after 16 weeks ( p =0.023). The improvement in the MoCA test in group 2 also began after 8 weeks., Conclusion: The authors recommend ALA in polyneuropathy as a drug that also has a positive effect on cognitive functions in DM-2 and dipyridamole for the treatment of patients with diabetic encephalopathy and cerebral small vessels disease and stroke.

Introduction: Oxidative stress of sperm is a common pathologic condition, which can be detected in 30-80% infertile men. It is established that dietary consumption of antioxidants and microelements contributes to an increase of conception probability in subfertile couples, and also reduces the risk of reproductive losses. Drug complexes influencing various factors of spermatogenesis disturbance (oligo-, astheno-, teratozoospermia), oxidative stress and the level of sperm DNA fragmentation are of greatest and reasonable interest., Aim: To study the effects of complex acetyl-l-carnitine, l-carnitine fumarate and alpha-lipoic acid (SpermActin Forte) on oxidative stress, ejaculate quality and sperm DNA fragmentation in men with infertility., Materials and Methods: A total of 80 infertile men aged 25-40 years with increased level of sperm DNA fragmentation and oxidative stress were included in open-label, prospective, randomized study. In Group A (n=20) patients received a placebo for 180 days, and in Group B patients were prescribed to SpermActin Forte, 1 sachet of 10 g once a day. The criteria for the efficiency of therapy included sperm analysis, the level of sperm DNA fragmentation, the level of sperm oxidative stress, as well as information about achievement of pregnancy, obtained by interviewing all participants., Results: In patients taking antioxidant complex SpermActin Forte there were significant positive changes in the main parameters of sperm analysis, including sperm mobility and morphology starting from the third month of therapy. The level of free oxygen radicals (as indicator of oxidative stress) in Group B also significantly decreased (by 86%). A more profound decrease in DNA fragmentation was seen in Group B compared to Group A (21.5% vs. 3.6%). Pregnancy was achieved in 1 and 13 cases in Group A and B, respectively., Conclusion: The use of the SpermActin Forte antioxidant complex allowed to improve sperm analysis in most patients, and these changes were significant starting from the third month of therapy. Stimulation of spermatogenesis using the antioxidant complex SpermActin Forte is an effective and safe method of treating male infertility.

α-Lipoic acid (also known as thioctic acid) is a natural vitamin-like compound. Lipoic acid contains asymmetrical carbon, which causes the presence of two possible optical isomers (enantiomers): R-lipoic acid (levogyrate isomer) and S-lipoic acid (rightspinning isomer). Lipoic acid functions as a cofactor for several important mitochondrial multienzyme complexes, enhances the uptake of glucose by the cells, and modulates the activity of various signaling molecules and transcription factors. It was shown that α-lipoic acid and its derivative, dihydrolipoic acid, have a direct antioxidant effect due to the neutralization of reactive oxygen species that are destructive to DNA, proteins and lipids of cells. Dihydrolipoic acid enhances the antioxidant properties of ascorbic acid, glutathione and ubiquinone. Available evidence suggests that supplementation with lipoic acid reduces the symptoms of peripheral diabetic neuropathy. Results from randomized controlled trials show that high doses of lipoic acid can improve the glycemic profile of subjects with metabolic disorders. Lipoic acid can be used to control body weight in people with obesity. R-Lipoic acid is synthesized in the human body and is contained in foods in a form covalently associated with lysine (lipoyllysine). Its dose in dietary supplements significantly exceeds the amount in the diet. Most dietary supplements contain a racemic mixture of R- and S-lipoic acid., Competing Interests: The authors declare no overt and potential conflict of interest related to the publication of this article., (Copyright© GEOTAR-Media Publishing Group.)

The issues of classification, pathogenesis, pathomorphology and treatment of diabetic polyneuropathy (DPN) are addressed. Pathogenetic mechanisms of the action of alpha-lipoic acid in treatment of DPN are justified. The authors present the results of randomized placebo-controlled trials of alpha-lipoic acid that revealed the high clinical efficacy and absence of side-effects even during the long-term treatment.

Authors present a case-report of a 36-year-old patient with pain syndrome in the face region (craniomandibular dysfunction with occlusive disorders) involving pericranial muscles and shoulder girdle muscles. Thioctic acid was prescribed as a basic therapy, and relaxation tire, mimic gymnastics, post-isometric relaxation, vitamin and mineral complex were additionally used. Thioctic acid was prescribed according to the following scheme: stage I - intravenous injections of thioctic acid (600 mg/daily, 5 procedures, every other day); stage II - oral administration of the drug in the dose of 600 mg/daily for 3 months. A significant reduction of pain syndrome and the palpable tension of muscles were noted; the symmetric even muscle tone was revealed. This case-report demonstrates the high efficacy of thioctic acid in treatment of patients with craniomandibular disorders using the 2-stage scheme. There was a significant improvement of quality of life of the patients due to the additional use of vitamin and mineral complex and medical tools (relaxation tire) for treatment at all stages of pain formation.

α-Lipoic acid, or thioctic acid, (ALA) is the most applicable pharmacological drug for treatment of diabetic polyneuropathy. The article explores the results of experimental studies on the α-lipoic acid effect on mechanisms of peripheral nerves affection in hyperglycemia as well as the data of numerous randomized controlled trials and meta-analyses on studying ALA efficacy in symptomatic diabetic polyneuropathy. It has been shown that amelioration of patients with diabetic polyneuropathy is observed both for ALA infusions and tableted form of the drug. The authors conclude that α-lipoic acid is a drug for treatment of pathogenetic development mechanisms of diabetic polyneuropathy with the best proven efficacy.

Aim: To perform a comparative study of anxiolytic and antidepressant effects of derivatives of 3-oxypyridine and succinic acid (emoxipine, reamberin and mexidol) in experimental diabetes mellitus., Material and Methods: An effect of emoxipine, reamberin and mexidol on manifestations of anxiety in 'elevated plus maze' (EPM) and duration of 'desperate behavior' (DB) in Porsolt test in rats with alloxan diabetes during medication course was studied. Alpha-lipoic (thioctic) acid (α-LA) was used as a reference drug. In additional experimental series, an effect of emoxipine, reamberin, mexidol and α-LA on the intensity of hyperglycemia in experimental DM was investigated., Results and Conclusion: All studied medications used in doses equivalent to therapeutic range in humans and administered for 14 days significantly reduced manifestations of anxiety and depression in rats with alloxan diabetes. The most pronounced anxiolytic potential was demonstrated for emoxipine that emerged as the only medication in the study that reduced manifestations of anxiety not only in comparison with 'alloxan diabetes-control' groups but also in comparison to 'intact control'. The intensity of tranquilizing activity of derivatives of 3-oxypyridine and succinic acid was similar to that of α-LA while the thymoanaleptic activity, when the drugs were administered in maximal doses to rats with experimental DM, was higher. Both emoxipine and mexidol as well as α-LA in all studied doses significantly decreased hyperglycemia in alloxan diabetes. Reamberin demonstrated only insignificant tendencies of the same trend.

In this article, the authors consider the characteristics of pathogenesis and clinical picture of peripheral nervous system lesions in elderly patients. Current approaches to pathogenetic and symptomatic treatment of polyneuropathy in elderly patients are analyzed. The authors suggest complex treatment approaches using antiepileptic drugs, group B vitamins, alpha-lipoic acid.

The study proved important role of antioxidants in combined therapy for patients with vibration disease caused by general and local vibration. Findings are positive influence of thioctic acid on amelioration of pain and angiodystonia, supported by clinical and functional investigations.

Objective: To evaluate the efficacy and tolerability of axamon (ipidacrine) therapy in patients with focal neuropathies--mononeuropathies., Material and Methods: We examined 35 patients, aged 18 years and older, with focal neuropathies (tunnel syndromes, radiculopathies). In the main group (n=20) axamon (ipidacrine) was prescribed in addition to the basic (standard) therapy (group B vitamins, lipoic acid) during 6 week, in the control group (n=15) patients remained only on the basic (standard) treatment., Results: In the main group positive clinical changes were accompanied by the more significant positive electroneuromyographic (ENMG) dynamics as compared to the control group (the increased amplitude of M-response in the muscles of the hand and feet; increased nerve conduction velocity in the peripheral nerves as a manifestation of remyelination activity, and others)., Conclusion: The obtained clinical and ENMG data indicate that axamon (ipidacrine) is a unique cholinesterase inhibitor with conduction action primarily targeting on efferent (motor) fibers of the peripheral nerves.

Presence of comorbidity in patients--that is essential hypertension and type 2 diabetes is associated with early progression of target organs affection and cardiovascular complications. Hyperinsulinemia and insulin resistance are some of the factors that determine the frequency of cardiovascular complications in type 2 diabetes. According to some authors, endothelial dysfunction is a link between insulin resistance and cardiovascular diseases. To investigate severity of endothelial dysfunction in patients with essential hypertension and type 2 diabetes and its correction by using a complex treatment α-lipoic acid we have examined 84 patients with essential hypertension stage II and type 2 diabetes in a moderate condition before and after 6 months treatment. The patients were divided into two groups: the first one consisted of the patients who received only basic therapy, and another one consisted of those patients who in addition to basic therapy received also α-lipoic acid in tablets at a dose of 600 mg/day. After the investigation it was discovered that changes in the vascular wall in patients with essential hypertension and type 2 diabetes are characterized by increase of intima-media thickness and pulse wave velocity in the carotid arteries and abdominal aorta, decrease of endothelium-dependent vasodilation degree and increase of the levels of proinflammatory cytokines. Under the influence of the mentioned complex therapy in these patients it was found some improvement of metabolic homeostasis and correction of endothelial dysfunction. The effect on the structural and functional state of great vessels and proinflammatory cytokines, gained due to additional prescription of α-lipoic acid to the patients with essential hypertension and type 2 diabetes, was more considerable that the one which was shown in the group of patients who received only standard therapy.

Objective: The effect of original domestic derivatives of 3-oxypiridine and succinic acid (emoxipine, reamberin and mexidol) on the resistance to acute brain ischemia was studied in an experimental mouse models., Material and Methods: We used 260 adult outbred mice. The drugs were introduced intraperitoneally 30 min before the modeling of acute brain ischemia. Each drug was used in 3 three doses: 1/2 of the calculated equivalent of mean treatment dose (EMTD), EMTD and double EMTD. A strangulation model with the assessment of mouse mortality latency and decapitation model with the assessment of agonal respiration (gasping) were used. The efficacy of the drugs was determined by comparison against alpha-lipoic acid that was used as a reference substance in previous studies of antihypoxic activity of emoxipine, reamberin and mexidol., Results and Conclusion: It was established that the derivatives of 3-oxipiridine and succinic acid protected against subtotal ischemia of rostral brain segments (of cerebral hemispheres) as evidenced by the increase in longevity. Emoxipine demonstrated the maximal effect thereby surpassing reamberin and mexidol in the intensity of antiischemic activity. Antiischemic effect of alpha-lipoic acid was comparable to emoxipine. In the model of total brain ischemia, the derivatives of 3-oxipiridine and succinic acid caused the opposite (proischemic) action on the bulbar respiratory center as evidenced by the reduction in duration of gasping. Alpha-lipoic acid did not affect the duration of gasping.

The results of experimental studies and clinical trials of alpha-lipoic acid drugs are presented. Antioxidant and neuroprotective effects provide the efficacy of these drugs in patients with different diseases of the central and peripheral nervous systems. Good tolerability and possibilities of using in combinations with other drugs give grounds for a wide application of the drug in neurological practice.

Installed significantly more pronounced positive effect on clinical manifestations and laboratory indicators of liver in patients with chronic alcoholic hepatitis who received within 4 weeks of basal therapy in conjunction with Gepatomax Forte in comparison with a group of patients with chronic alcoholic hepatitis who received during the same time only basic therapy. Side adverse effects in the group of patients receiving Gepatomax Forte were not registered.

We studied the effect of deproteinized hemoderivative of calf blood, thioctic acid and vinpocetine with piracetam on the endothelial function in patients with chronic cerebral ischemia stage III. After pharmacological treatment, there was the improvement in the endothelium properties of both large and small blood vessels. The index of occlusion that characterized the function of small vessels reached normal values while the phase shift did not approach to the reference values. This notion indicates that in cerebral atherosclerosis small arteries initially are subject to alterations to a lesser extent compared to the arteries of large and medium caliber. The most effective medicines of those used for the correction of endothelial dysfunction are deproteinized hemoderivative of calf blood and thioctic acid.

Thiolepta (alpha-lipoic acid preparation) was used in treatment of 205 patients, 134 women and 71 men, mean age 59.3±10.1 years; 196 patients with diabetes mellitus (DM) type II and 9 patients with DM type I. Treatment duration was 4 weeks. Dosage of the drug was 600 mg daily. Patients were assessed neurologically and with psychometric scales. Special attention was drawn to the severity of positive and negative symptoms of neuropathy and sleep disorders. The results demonstrated the efficacy of thiolepta in diabetic polyneuropathy assessed by all parameters. The effect remained during 3 months after the end of treatment. Good tolerability and safety of the drug are highlighted.

Eighty-one patients with diabetes mellitus type 2 (DM) and cardiovascular autonomic neuropathy were studied. The combined treatment with ω-3 PUFA, benfotiamine, and α-lipoic acid resulted in significant positive changes in total cholesterol, triacylglycerol, LDL and HDL cholesterol levels. The efficacy of this treatment was not associated with the improved compensation of DM but was a result of the direct influence of pharmacological agents on the metabolic rate studied.

We studied the efficacy of rheosorbilact, an original infusion drug based on polyalcohols, in the complex therapy of patients with brain ischemia and diabetic neuropathy. Reosorbilact was used intravenously indrops 200-400 ml in day - 20 days. The primary endpoint of the study was the improvement of quality of life assessed with the SF-36 scale after 1 month of treatment. Patients with brain ischemia underwent neuropsychological tests and ultrasound duplex scanning of the carotid and vertebral arteries. In the group of patients with diabetic neuropathy, we evaluated the intensity of pain syndrome with the NRS, blood glucose level and electroneuromyography parameters of low extremities nerves. Some characteristics of acid-base balance were studied in patients of both groups. The results obtained in the study indicate the significant clinical effect of reosorbilact in patients with brain ischemia and diabetic neuropathy.

Frequency and nosological attribution of demyelinating polyneuropathies in patients with diabetes mellitus and alcoholism were determined. Eighty-six inpatients with alcoholic (n=46) and diabetic (n=40) polyneuropathy were examined clinically and using electroneuromyography (ENMG). A demyelinating pathogenetic variant was identified by clinical and ENMG data in 27 (31%) patients. Nine patients (33%) had dysimmune polyneuropathies (acute and chronic inflammatory demyelinating polyneuropathy). Polyneuropathies were specified as toxic/metabolic with the prevalence of a demyelinating component within the main disease in 18 (67%) patients. Clinical and ENMG-signs of the demyelinating variant of alcoholic and diabetic neuropathy are presented. The efficacy of the antioxidant berlition was shown for toxic/metabolic polyneuropathies while the addition of immune modulators was needed for treatment of dysimmune polyneuropathy.

Distal symmetric sensory-motor diabetic polyneuropathy (DPN)--the most common variant of diabetic neuropathy, which is expressed by more than 50% of patients with diabetes mellitus (DM) 1 and type 2. The pathogenesis of DPN is the damaging effect of chronic hyperglycemia. Based on this key trends in the pathogenetic treatment of DPN are the normal levels of blood glucose, improved tissue perfusion and oxygen consumption, improve the rheological properties of blood, to restore normal energy balance, reducing the severity of oxidative stress.

We studied the effect of antioxidants such as N-acetylcysteine (NAC, 10 mM) and alpha-lipoic acid (ALA, 1.25 mM) and of the hormone melatonin (1 microM) on the ability of murine hepatoma cells MH22a to develop tumors in syngenic mice (C3HA) after subsutaneous injection. Tumor formation and development slowed down and mouse mortality decreased when the injected cells were pretreated by NAC, ALA or melatonin during 20 h. Melatonin had the most marked effect. Tumors appeared in 100 % cases after 10 days in control mice when untreated cells had been injected; injection of cells pretreated by NAC or ALA resulted in tumor formation only in 40 and 53 % of mice, respectively. When cells were pretreated with melatonin the tumors appeared only in 18-20 days after injection. Until the end of the observation (36 days) 67 % of control mice died, but when the cells were pretreated by NAC or ALA mouse death-rate was 20 and 53 %, respectively. In the case of melatonin we did not observed any dead mice at all. We showed that treatment by antioxidants delayed (NAC) or completely inhibited (ALA) cell cycle of hepatoma cells. Cell cycle was restored after removal of the antioxidants. Melatonin did not change cell cycle phase distribution. We conclude that there is no direct correlation between loss of tumorigenic properties and changing of proliferative activity of hepatoma cells. Different mechanisms of antioxidants and melatonin action resulting in transient tumor phenotype normalization are discussed.

Relationship between the antihypoxic effect of 3-hydroxypyridine and succinic acid derivatives (emoxipine, reamberin and mexidol) and their effect on conditional learning, glycemia, and lipidemia was studied in rats with alloxan-induced diabetes. In parallel, the analogous relationship was investigated for alpha-lipoic acid that is regarded as a "gold standard" in treatment of diabetic neuropathy. It was established that single administration of emoxipine and mexidol in mice in doses equivalent to therapeutic-range doses in humans produces antihypoxic effect manifested by increased resistance to acute hypoxic hypoxia in test animals. Alpha-lipoic acid is inferior to emoxipin and mexidol in the degree of antihypoxic action. Reamberin does not exhibit this effect. The introduction of emoxipin, reamberin, mexidol, and alpha-lipoic acid in rats with alloxan diabetes during 7 or 14 days in doses equivalent to therapeutic-range doses in humans corrects conditional learning disorders in direct relationship with the antihypoxic activity of these drugs. The development of the nootropic effect of emoxipin, mexidol, and alpha-lipoic acid is related to a decrease in hyperglycemia and hyperlipidemia in rats with alloxan diabetes. The nootropic action of reamberin is accompanied by a transient hypoglycemizing effect and aggravation of dyslipidemic disorders. The antihypoxic activity of investigated drugs determines the direction and expression of their lipidemic effect, but is not correlated with the hypoglycemizing action these drugs on test animals with alloxan diabetes.

Short-term, prospective placebo-controlled simple blind randomized study of the effects of alpha-lipoic acid and mexidol on the dynamics of affective status disorders, cognitive functions, and quality of life in parallel with changes in carbohydrate metabolism and lipidemia has been conducted in diabetic patients. It is established that two-week administration of alpha-lipoic acid (600 mg once a day, i.v.) and mexidol (300 mg once a day, i.v.) reduced hyperglycemia by 13.00 with simultaneous decrease of depressive "feelings of guilt". In case of mexidol, these effects were accompanied by positive "vitality" dynamics established with SF-36 questionnaire and reflecting improvement in patients' quality of life. Additionally, course administration of alpha-lipoic acid increased attention as studied with Schulte tables. Favorable psychotropic effects of alpha-lipoic acid and mexidol were unrelated to changes in lipidemia and "lipid peroxidation - antioxidant protection" system indicators.

Data of literature on the role of inflammation factors in the pathogenesis of stroke are presented. The study of myeloperoxidase level in the early acute phase of ischemic stroke and dynamics of this parameter after the antioxidant treatment with the α-lipoic acid preparation berlition was carried out. It has been shown that the activation of systemic inflammation and related oxidative stress recorded in the early acute phase of brain infarction needs pharmacological treatment. Neuroprotective action of α-lipoic acid related to the prevention of damaging effect of free radicals on cell membranes and reduction of oxidative stress intensity is a pathogenetic explanation for using its preparations in ischemic brain lesions. The decrease in plasma myeloperoxidase content after the treatment with berlition may consider as a criterion of its efficacy.

The authors have studied structural functional peculiarities of the left ventricle in patients with type 2 diabetes mellitus, dependent on the presence of cardiovascular form of diabetic autonomic neuropathy and dynamics of the studied parameters in patients with type 2 diabetes mellitus complicated with cardiovascular form of diabetic autonomic neuropathy treated with alpha-lipoic acid. The study included 82 patients with type 2 diabetes mellitus. The study has shown that the development of cardiovascular form of diabetic autonomic neuropathy results in dilatation and hypertrophy of the left ventricle walls, increase of its weight and impairment of diastolic function of the left ventricle manifesting itself by a decrease of early filling phase and an increase of myocardial hardness, as well as a decrease of cardiac rhythm variability and increase of QT-interval. Use of alpha-lipoic acid in complex treatment of diabetic autonomic neuropathy contributes to more effective influencing on diastolic function of the left ventricle and electrophysiological properties of the myocardium.

Reviewed herein is the present-day literature data concerning the causes leading to the development of ischemic stroke. Special attention is drawn to the haemodynamic mechanism, of cerebral circulation impairment. Also discussed is the fed of the onset of such disorders in patients suffering from peripheral atherosclerosis during reconstructive surgical vascular interventions, in relation with a multifocal nature of the lesion. Presented are modern findings on diagnostic methods making it possible to assess autoregulatory disorders of cerebral circulation, the main causes of these impairments, as well as potential principles of correction thereof.

Peroral administration of taurine and thioctacide in rats with alloxan-induced diabetes (i) decreased the levels of glucose, fructosamine and MDA, (ii) increased the levels of glycogen, insulin, and C-peptide in the liver, and (iii) increased the levels of enzymes of the antioxidant system of catalase and paraoxonase as compared to the control group of animals. These effects show that taurine and thioctacide possess hypoglycemic and antioxidant properties.

Berlition, an alpha-lipoic acid preparation, is a natural regulator of the free-radical processes. It was used as an add-on therapy in the management of patients in the acute period of ischemic stroke during 10 days. A main group included 15 patients treated with berlition and a comparison group - 11 patients who received a basic therapy. Patients' age was 30-60 years. A complete clinical study of patients was conducted during 21 days of treatment. CT perfusion imaging of the brain with contrast material was carried out on 1st, 5th and 15th days. The higher therapeutic effectiveness was found in the main group of patients, with complete functional rehabilitation in 33% of cases and significant regress of neurologic symptoms in 67%. These changes were correlated with positive shifts of different hemodynamic parameters to the 15th day of treatment.

The changes of glutathione metabolism are rare in dyscirculatory encephalopathy and ischemic stroke (IS) of mild severity. The frequent and considerable changes have been revealed in IS of moderate and high severity as well as in hemorrhagic stroke. An increase of activities of glutathione peroxidase and glutathione transferase is the most typical. The increase of enzyme activity was not observed at the beginning of treatment after 3 days and in patients with severe degree of disease who died later. A standard therapy decreased the quantity and/or expression of changes of the glutathione metabolism in patients with IS of moderate and high severity while the addition of alpha-lipoic acid (alpha-LA) led to the complete normalization in IS of moderate severity and normalization of most parameters in IS of high severity. The increase of functional activity of the glutathione system at the early stage of treatment of IS and the favorable changes during the treatment, in particular after the addition of alpha-LA, were correlated with the improvement of neurological status assessed with the NIHSS. It has been confirmed that the glutathione system plays an important role in the tolerance to brain ischemia.

The study was designed to investigate effect of alpha-lipoic acid (alphaLA) and mexidol on clinical manifestations of diabetic neuropathy (DN) and the associated changes of the affective status in patients with diabetes mellitus at early stages of diabetic foot syndrome (DFS). Integral indicator of clinical symptoms of distal symmetric sensorimotor polyneuropathy (according to the neuropathic signs and symptoms scale) significantly decreased within 14 days after the onset of the treatment with alphaLA (600 mg/day) and mexidol (300 mg/day). Antineuropathic effect of alphaLA was associated with a rise in the left ventricular ejection fraction. Mexidol reduced the severity of DN-related depression and was more efficacious than alphaLA in terms of beneficial effect on spasms and paresthesia (pricking and burning sensation, numbness) in distal segments of the lower extremities. The above clinical effects of alphaLA and mexidol were unrelated to changes of glycemia, lipidemia amd lipid peroxidation.

Fifty-four patients diagnosed with distal sensomotor diabetic polyneuropathy of low extremities have been studied. All patients suffered from diabetes mellitus type 2 and had signs of retinopathy. It has been shown that berlition in dosage 300 mg twice daily for 3 months exerts a significant positive effect on the state of sensory and motor functions as well as neurophysiologic disturbances. The effect is increased significantly, especially in the sensory sphere (tactile, temperature and pain sensitivity), when the drug is used in combination with curantyl in dosage 50 mg twice daily for 3 months. The positive influence of this combination on the development of retinopathy is also observed.

Twenty-eight patients, 17 women and 11 men, aged 40-70 years, with distal sensory-motor diabetic neuropathy of the lower extremities were treated with berlition, an alpha-lipoic acid preparation, in dosage 600 mg daily during 3 months. The treatment resulted in the significant reduction of clinical (sensory and motor) and neurological changes of lower extremity peripheral nerves.

A role of the free-radical processes and disturbances of oxidative-restorative blood homeostasis and nervous tissue in the pathogenesis of brain ischemic pathology and other diseases are reviewed. Attention is focused on the search for optimal ways of pharmacological correction of oxidative stress in the schemes of complex treatment of chronic blood circulation insufficiency and on the necessity of combined application of several antioxidants with different mechanisms of action which reciprocally potentiate each other. Experimental and clinical suppositions of the use of a-lipoic acid as one of the most studied antioxidant in the treatment of brain ischemia as well as the results of own studies on the preparation berlition which contains a-lipoic acid used in the neuroprotective therapy of chronic brain ischemia for correction of free-radical processes are discussed.

The influence of lipoic acid on the energy homeostasis in rats with chronic generalized parodontitis has been investigated. Lipoic acid possesses the energy-saving activity, which is related to an increase in oxidative phosphorylation efficiency.

Regional anesthesia was studied for its impact on the functional status of a peripheral nerve in 20 patients with purulent diseases of the lower extremities in the presence of diabetes mellitus. The impact of conservative therapy on the peripheral nerve was also studied in these patients. There was no negative impact of regional methods of anesthesia on the function of the nerve, its improvement due to treatment with alpha-lipoic acid and serotonin adipinate.

The efficacy of conventional complex treatment and such, including pentoxyphylline, lipoic acid and the aminoacids mixture, was studied in early postoperative period in 64 patients with an acute destructive pancreatitis. The highest levels of general and direct bilirubins, the aminotransferases activity were established initially in those patients, in whom the polyorgan insufficiency syndrome (PIS) occurred subsequently. More significant normalization of the indexes under the influence of treatment was observed in patients without PIS, in patients with PIS the pharmacological resistance was registered. More favourable course of postoperative period was observed in patients, in whom pentoxyphylline, lipoic acid and the aminoacids mixture were included in complex of treatment.

The absence of clinical, biochemical, and instrumental signs that characterize the morphological pattern of the liver presents an urgent problem in the diagnosis of alcoholic hepatitis (AH). Sixty-one patients (mean age 41.7 +/- 8.7 years) were examined to study relationships between the histomorphological parameters and laboratory and instrumental findings in patients with AH on combined treatment including alpha-lipoic acid (Berlition). Indirect assessment of the histological activity of the disease may use the parameters of the serum activity of aspartate aminotransferase and gamma-glutamine aminotransferase, the stages of hepatic fibrosis-ultrasound symptoms: the splenic index at the early stages of the disease, the diameter of the splenic vein in moderate and severe fibrosis. The supplementation of Berlition in the combined therapy for AH decreases the severity of fatty hepatocytic dystrophy, hepatic inflammatory and necrotic changes, no increase or a decrease in the stage of fibrotic changes in the liver tissue.

A comparison study of efficacy and tolerability of the drug berlition 300 oral and berliton 300 U and vitamin B1 has been conducted in 56 patients with alcohol polyneuropathy (15 female, 41 male, mean age 42.6 years). The key mechanisms of berlition action are increasing of endoneural blood flow, strengthening of antioxidant system functioning and reduction of "oxidative stress" intensity; improvement of glucose consumption and restoring of nerve energetic balance as well as intensification of nerve growth factor releasing and nerve growth acceleration after its experiment cutting or squeezing. Usage of berlition in the cohort studied was accompanied by a positive dynamics of both subjective and objective clinical symptoms. Comparing to vitamin B1, the drug was significantly more effective by clinical and electrophysiological indices. Berlition therapy is tolerable and safe. The results of the study confirm an assumption of berlition efficacy in alcohol polyneuropathy and allow to recommend the drug for a wide clinical application.

Effects of the antioxidant berlithione (alpha-lipoic acid) on indices for the immune system, such as complement titer, C3-component of the complement, reaction of the autorosette formation were studied together with those on parameters characterizing cell-bound and humoral immunity. 11-12 years following the Chernobyl accident, nine liquidators of its aftermaths were examined, aged 51.8 +/- 7.2 years, body mass (BM) 27.3 +/- 4.2 kg/m2, radiation dose 73.2 +/- 35.3 rem, who took part in the elimination of the effects of the accident for no more than 3 months in 1986--at the beginning of 1987. All examinees were prescribed the drug berlithione (alpha-lipoic acid), 600 mg per day over two months. A two-month treatment with berlithione, 600 mg/day, resulted in normal levels of indices for unspecific defence; among these were phagocytic activity of neutrophiles, content of the complement, its C3-component, and reaction of autorosette formation in the accident effects liquidators, but no impact was found on cell-mediated and humoral immunity.

Medication Berlition 300 oral, produced by "Berlin-Hemie", induces lower serum iron content, decrease in transferrin content of whole blood and serum proportionally to increased urinary iron excretion and lower serum bilirubin and normalizes serum glucose level. Berlition 300 oral, lipoic acid preparation made by "Berlin-He mie" (Menarini group), could be recommended for treatment of high serum iron content and iron overload, especially in association with diabetes mellitus.

A total of 45 patients (90 eyes) with stages I and II open-angle glaucoma (OAG) were examined, 26 of these were administered lipoic acid in a daily dose of 0.075 g for 2 months and 19 were given 0.15 g daily for 1 month. Control group consisted of 31 patients with OAG who were administered only local hypotensive therapy. Vision acuity and visual field were checked up, tonometry, tonography, and campimetry carried out, and levels of nonprotein SH-groups and activity of gamma-glutamyl transpeptidase measured in the lacrimal fluid. Improvement of the biochemical parameters, visual function, and of the coefficient of efficacy of liquid discharge was more expressed in the patients administered lipoic acid in a daily dose of 0.15 g. Color campimetry results indicate improved sensitivity of the visual analyzer under the effect of treatment. Improvement was attained in approximately 45-47.5% of examined eyes, and was more often seen in patients with stage II OAG: in 57-58% eyes. The effect of lipoic acid may be explained by its antioxidant properties and direct influence on ocular tissue metabolism.

Nonprotein SH groups and gamma-glutamyl transpeptidase were detected in the lacrimal fluid of patients with open-angle glaucoma and senile cataract and in controls (in 82 and 100% of the examinees, respectively). In stage II glaucoma SH group level was found reduced vs. that in stage I or control. Intake of lipoic acid by patients with stage II glaucoma resulted in a reliable increase of lacrimal SH group level. Measurements of lacrimal fluid nonprotein SH groups may be used to monitor antioxidant therapy of patients with open-angle glaucoma.

A total of 151 patients with open-angle glaucoma, 23 ones with closed angle glaucoma, and 57 ones with age-associated cataracts were examined. The reference group consisted of 21 subjects with posttraumatic cataracts (1.5 years after the injury) and normal subjects. Nonprotein sulfhydryl groups (glutathione) were measured in the peripheral blood, aqueous humor, and in tissue samples from the scleral drainage sites, obtained in antiglaucoma surgery and in surgery for cataract extraction. Aqueous humor of patients with posttraumatic cataracts, blood samples of these patients and normal subjects were examined for control. The level of sulfhydryl groups was found significantly lowered in the anterior chamber humor of patients with open-angle glaucoma, particularly in those with disease Stages II and III as against the controls. The content of sulfhydryl groups was lowered in the tissue samples from the scleral drainage area of patients with open-angle glaucoma Stages II and III vs. that in the patients with Stage I condition. Similar changes were found in the red cells of patients with Stages II and III open-angle glaucoma. Glutathione is an important component of the cellular antioxidant system. The findings point to a reduction of the processes of antioxidant defense of ocular tissues, developing as early as in the first stage of open-angle glaucoma. Lipoic acid administration for 2 months was associated with a rise of glutathione level in the red cells of patients with Stages II and III open-angle glaucoma.